Skip to main content
main-content

01.12.2015 | Ausgabe 4/2015

Endocrine Pathology 4/2015

The Complementary Role of Transcription Factors in the Accurate Diagnosis of Clinically Nonfunctioning Pituitary Adenomas

Zeitschrift:
Endocrine Pathology > Ausgabe 4/2015
Autoren:
Hiroshi Nishioka, Naoko Inoshita, Ozgur Mete, Sylvia L. Asa, Kyohei Hayashi, Akira Takeshita, Noriaki Fukuhara, Mitsuo Yamaguchi-Okada, Yasuhiro Takeuchi, Shozo Yamada

Abstract

Clinically nonfunctioning pituitary adenomas (NFAs) may be hormonally inactive tumors of differentiated cells, mainly not only gonadotroph adenomas (GAs) but also silent corticotroph adenomas (SCAs) and other differentiated silent adenomas. Recently, the use of transcription factors has been recommended to confirm cytodiffererentiation of these neoplasms. Our objective was to assess the clinical significance of the new classification system using transcription factors. Five hundred sixteen consecutive NFAs were studied retrospectively. They were initially classified based on hormone immunohistochemistry as follows: 119 hormone-negative adenomas (23.1 %), 300 GAs (58.1 %), 51 SCAs (9.9 %), and 46 other silent adenomas. The 119 hormone-negative adenomas were further evaluated for expression of transcription factors including steroidogenic factor-1 (SF-1), estrogen receptor-α (ERα), pituitary-specific transcription factor 1 (Pit-1), and t-box transcription factor (Tpit). One hundred thirteen of 119 (95 %) hormone-negative adenomas showed mutually exclusive lineage-specific differentiation as gonadotrophs (SF-1 positive), corticotrophs (Tpit positive), or somatotrophs/mammosomatotrophs/lactotrophs/thyrotrophs (Pit-1 positive) in 79 cases (66.4 %), 32 cases (26.9 %), and 2 cases, respectively. The 32 ACTH-negative and Tpit-positive adenomas had higher pro-opiomelanocortin mRNA expression levels compared with GAs (P = 0.0001) on quantitative real-time PCR. They showed a female preponderance (P < 0.0001) and were more frequently giant adenomas (P = 0.0028) associated with marked cavernous sinus invasion (P < 0.0001) compared with GAs. These clinical features were identical to those of the 51 ACTH-positive SCAs. Our results justify the complementary role of transcription factors in the precise classification of NFAs that can more accurately characterize biological behavior. Our data suggest that more than one quarter of hormone-negative adenomas are SCAs that share distinct clinicopathological features with ACTH-expressing SCAs.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

★ PREMIUM-INHALT
e.Med Interdisziplinär

Für Ihren Erfolg in Klinik und Praxis - Die beste Hilfe in Ihrem Arbeitsalltag als Mediziner

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf SpringerMedizin.de.

Alle e.Med Abos bis 30. April 2021 zum halben Preis!

Jetzt e.Med zum Sonderpreis bestellen!

Weitere Produktempfehlungen anzeigen
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 4/2015

Endocrine Pathology 4/2015 Zur Ausgabe
  1. Sie können e.Med Innere Medizin 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.

Neu im Fachgebiet Pathologie

05.03.2021 | Forensische Psychopathologie | CME | Ausgabe 2/2021

Tötungsdelikte im Gesundheitswesen – Teil 1

Hintergründe und Besonderheiten

01.03.2021 | COVID-19 | Schwerpunkt: COVID-19 | Ausgabe 2/2021 Open Access

COVID-19: Auswirkungen auf das zentrale und periphere Nervensystem

01.03.2021 | COVID-19 | Schwerpunkt: COVID-19 | Ausgabe 2/2021 Zur Zeit gratis

Biologie und Pathologie von Coronaviren

01.03.2021 | COVID-19 | Schwerpunkt: COVID-19 | Ausgabe 2/2021 Zur Zeit gratis

Nachweismethoden von SARS-CoV-2 in Gewebe